Stents Overused in Stable Heart Patients
Study Finds No Benefit of Stents Over Using Medications First
No Survival Advantage in Stent Patients
Roughly half received stents with medication and the other half received medication alone.
Over an average of 4.3 years of follow-up, there was no evidence of benefit in preventing death, non-fatal heart attacks, heart-related chest pain, or emergency need for bypass surgery seen in people who received stents along with medication compared to people treated with medication alone.
The researchers estimate that up to 76% of patients with stable heart disease could avoid angioplasty and stenting procedures if initially treated with medication, resulting in a savings of about $9,500 per patient.
Practice Is Changing ... Slowly
American Heart Association President Gordon Tomaselli, MD, agrees that too many angioplasty and stenting procedures are being done in a non-emergency situation, but he says the growing evidence in favor of drug management as initial therapy is slowly changing practice.
Tomaselli directs the division of cardiology at Johns Hopkins University School of Medicine.
“As more and more studies show that medicine works well and is cheaper and less risky than these interventions, I think practitioners -- even interventional cardiologists -- will be adopting this strategy more and more,” he tells WebMD.
Interventional cardiologist Howard Cohen, MD, of Lenox Hill Hospital in New York City, acknowledges that there is still overuse of stenting, but he says most practitioners in his field are following the AHA/ACC guidelines.
“Most people are trying to do the right thing and are following the appropriate use criteria to make sure these interventions are being given for the right reasons,” he says.